78264
HCPCS Procedure Code
HCPCS code 78264 is the #2,402 most-billed Medicaid procedure code, with $6.1M in payments across 47K claims from 2018–2024. The national median cost per claim is $68.19. Costs vary widely — the 90th percentile is $274.21 per claim, 4.0× the median.
Total Paid
$6.1M
0.00% of all spending
Total Claims
47K
Providers
274
Avg Cost/Claim
$129
National Cost Distribution
How much do providers bill per claim for 78264? Based on 273 providers billing this code nationally.
Median
$68.19
Average
$124.04
Std Dev
$123.33
Max
$654.46
Percentile Distribution (Cost per Claim)
50% of providers bill between $25.73 and $207.26 per claim for this code.
90% bill between $19.56 and $274.21.
Top 1% bill above $539.83.
About This Procedure
HCPCS code 78264 was billed by 274 providers across 47K claims, totaling $6.1M in Medicaid payments from 2018–2024. This code was used for 43K unique beneficiaries.
Risk Assessment
Billing Statistics
Median Cost/Claim
$68.19
Providers Billing
273
National Spending
$6.1M
Avg/Median Ratio
1.82×
Moderately skewed
Top Providers Billing This Code
Ranked by total Medicaid payments for 78264
| # | Provider | Total Paid |
|---|---|---|
| 1 | Uofl Health-louisville Inc Louisville, KY · Psychiatric Hospital | $711K |
| 2 | Norton Hospitals Inc Louisville, KY · General Acute Care Hospital | $370K |
| 3 | 1972004489 | $247K |
| 4 | Norton Hospitals, Inc Louisville, KY · General Acute Care Hospital | $244K |
| 5 | 1699874248 | $178K |
| 6 | Virginia Commonwealth University Health System Authority Richmond, VA · General Acute Care Hospital | $176K |
| 7 | Owensboro Health Inc Owensboro, KY · General Acute Care Hospital | $168K |
| 8 | Regents Of The University Of Michigan Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | $168K |
| 9 | Ohio State University Hospitals Columbus, OH · General Acute Care Hospital | $141K |
| 10 | Beverly Radiology Medical Group Iii Los Angeles, CA · Radiology, Diagnostic Radiology | $140K |
| 11 | Presbyterian Healthcare Services Albuquerque, NM · Emergency Medicine | $139K |
| 12 | The Cleveland Clinic Foundation Cleveland, OH · General Acute Care Hospital | $132K |
| 13 | 1689282147 | $126K |
| 14 | Yale New Haven Hospital New Haven, CT · General Acute Care Hospital | $125K |
| 15 | Tucson Medical Center Tucson, AZ · Clinic/Center, Hearing and Speech | $110K |
| 16 | University Of Kentucky Lexington, KY · General Acute Care Hospital | $105K |
| 17 | 1144471715 | $105K |
| 18 | Stanford Health Care Stanford, CA · General Acute Care Hospital | $96K |
| 19 | Ashland Hospital Corporation Ashland, KY · Clinic/Center, Rural Health | $96K |
| 20 | Spectrum Health Hospitals Grand Rapids, MI · General Acute Care Hospital | $90K |
Showing top 20 of 274 providers billing this code